Obamacare in peril–would you be affected?

In a word, yes, if you have health insurance.

Do you have an adult child who is age 26 or less on your health insurance? Do you get comfort from knowing that your employer sponsored health insurance does not have a lifetime maximum limit? Have you purchased subsidized coverage in a State exchange and took solace that when comparing premiums you knew there were not tricky “gotcha” limitations in coverage that made lower premiums fools gold? Do you have a family member covered by the Medicaid expansion undertaken in 38 of 50 states?

The ACA aka as Obamacare brought about all of these changes that many now take for granted. However, on November 10, 2020–the week after the election–the Trump Administration is going to argue that the entire ACA should be thrown out as outlined in their brief. You could be forgiven for thinking, “haven’t they been talking about that for a decade?” Yes they have, but the dog could actually catch the car now that Ruth Bader Ginsburg has passed, even if she is not replaced prior to the election because a 4-4 tie would revert to the lower court that said “throw it all out.”

If President Trump is re-elected, then these provisions I noted and more are likely to be gone. If Joe Biden is elected, I suspect they will not and a compromise will be worked out.

The logic of the President’s case is as follows. In December, 2017, the Republican controlled House and Senate passed, and President Trump signed, a law that made the penalty for not purchasing health insurance under Obamacare equal to zero. If you choose not to buy health insurance since then, there is no penalty. That’s it. A lawsuit was brought saying that since the original ACA had a penalty for not purchasing insurance, now the entire law should be thrown out because the penalty has been set by the Republicans to equal zero. The folks who made the change to the law are now making the case to throw it all out because of that change. Yes, it is that dumb and ironic.

If you hear a Republican politician saying they support pre-existing condition limitation restrictions, keeping your adult children on your health insurance, no lifetime benefit maximums, health insurance coverage increases that are now taken for granted, ask them to write the bill they say would achieve those things while they are back in Washington confirming a Supreme Court Justice.

If you would like to do some research on your own, the Kaiser Family Foundation is the best source of non partisan, factual health policy information around.

About Don Taylor
Professor of Public Policy (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute), and Chair of the Academic Council at Duke University https://academiccouncil.duke.edu/ . I am one of the founding faculty of the Margolis Center for Health Policy. My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

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